DR. BENJAMIN WALLACE (NPI# 1033647516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033647516 |
| Entity Type | Individual |
| Full Name | DR. BENJAMIN WALLACE |
| Credential | DDS |
| Practice Address |
517 N Stone Rd Fremont MI 49412-9620 |
| Practice Telephone | 2319245542 |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2017-05-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2901022221 | MI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962913293 | Benjamin Levi Wallace | Nurse Practitioner | 264 Fm 3478 Rd, Huntsville, TX 77320-3322 | 2017-10-13 |
| 1467883108 | Benjamin Wallace | Emergency Medicine | 376 W 10th Ave, 776 Prior Hall, Columbus, OH 43210-1280 | 2013-12-05 |
| 1992936066 | Benjamin P Wallace | Physician Assistant | 3600 Nw Samaritan Drive, Suite 227, Corvallis, OR 97330-3737 | 2009-08-06 |
| Street Address |
517 N STONE RD |
| City | FREMONT |
| State | MI |
| Zip Code | 49412-9620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508289125 | Drs Fair and Niquette PC | Dentist | 517 N Stone Rd, Suite 102, Fremont, MI 49412-8629 | 2014-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437632437 | Claire Marie J Derks | Massage Therapist | 119 North Stone Road, Fremont, MI 49412 | 2018-09-14 |
| 1730565946 | Retirement Living Management of Fremont, L.L.C. | Assisted Living Facility | 801 E. Main Street, Fremont, MI 49412 | 2015-08-11 |
| 1497136410 | James Yon | Social Worker | 3682 S Maple Island Rd, Fremont, MI 49412 | 2015-06-16 |
| 1871864090 | Cheryl Lee Kublin | Specialist | 4554 W. 48th St, Fremont, MI 49412 | 2012-01-19 |
| 1326319583 | Colleen M Rice | Occupational Therapist | 4554 W. 48th Street, Fremont, MI 49412 | 2012-01-19 |
| 1154578847 | Greenlund Enterprises, Inc | Hearing Aid Equipment | 28 Wet Sheridan Street, Fremont, MI 49412 | 2008-08-25 |
| 1225170699 | Raymond Prins IIi | Dentist | 855 N Darling, Fremont, MI 49412 | 2007-02-13 |
| 1508933789 | Charles Merle Erickson | Dentist | 16 W Sheridan, Fremont, MI 49412 | 2006-11-30 |
| 1588741300 | Christopher Callis Niquette | Dentist | 327 Apache Dr, Fremont, MI 49412 | 2006-11-01 |
| 1417041179 | Newaygo County Resa | Local Education Agency (LEA) | 4747 W. 48th Street, Fremont, MI 49412 | 2006-10-03 |
| Find all providers in zip 49412 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275140881 | Bindi Satishkumar Patel | Dentist | 4261 Stevenson Blvd Apt 178, Fremont, CA 94538-2739 | 2020-09-28 |
| 1962057133 | Lais Mohammed Lodin | Dentist | 2895 Freeman Pl, Fremont, CA 94555-1413 | 2019-08-05 |
| 1730671736 | Justin J Shih | Dentist | 1895 Mowry Ave Ste 105, Fremont, CA 94538-1700 | 2018-06-05 |
| 1891298196 | Hergenrader Dental Rehab PC | Dentist | 3102 East Elk Lane, Fremont, NE 68025 | 2018-03-13 |
| 1588191738 | Rabia Qadir Memon | Dentist | 39355 California St Ste 100, Fremont, CA 94538-1447 | 2017-05-18 |
| 1376902155 | Priya Patel | Dentist | 4615 Rousillon Ave, Fremont, CA 94555 | 2016-02-22 |
| 1699134015 | Gentle Caring Dentistry of Fremont Ohio | Dentist | 2430 Enterprise St, Fremont, OH 43420 | 2016-02-12 |
| 1609246701 | Reginald Woo | Dentist | 4988 Paseo Padre Pkwy, 204, Fremont, CA 94555-3412 | 2015-10-01 |
| 1508243098 | Don Sin Dmd II Pa | Dentist | 102 S Sycamore St, Fremont, NC 27830-8709 | 2015-05-04 |
| 1134510654 | Nachiket J. Dave Dds, Inc | Dentist | 39489 Fremont Blvd., Fremont, CA 94438 | 2015-02-06 |
| Find all providers in FREMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.